Healthcare Provider Details

I. General information

NPI: 1578009973
Provider Name (Legal Business Name): SANBORN EYE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 INCHCLIFFE DR
GALES FERRY CT
06335-1807
US

IV. Provider business mailing address

1 INCHCLIFFE DR
GALES FERRY CT
06335-1807
US

V. Phone/Fax

Practice location:
  • Phone: 860-445-4412
  • Fax: 860-449-0343
Mailing address:
  • Phone: 860-445-4412
  • Fax: 860-449-0343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number2879
License Number StateCT

VIII. Authorized Official

Name: MEGHAN E LAMOUREUX
Title or Position: AUTHORIZED OFFICIAL, OPTOMETRIST
Credential: OD
Phone: 860-442-5058